The Relationship between Weight Status, Health-Related Quality of Life, and Life Satisfaction in a Sample of Spanish Adolescents

Life satisfaction among Spanish children and adolescents participating in Physical Education

Life satisfaction has been determined as a cognitive indicator of subjective wellbeing, a term that acquires vital relevance during adolescence as a protective factor against numerous psychological, mental and social disorders. Therefore, the objectives of this study are: (1) to evaluate differences in life satisfaction as a function of gender and school environment in Spanish children and adolescents; and (2) examine the possible associations between life satisfaction and age and/or body mass index (BMI) of the student body. For this purpose, a cross-sectional study was carried out with 723 students (aged 6 to 18 years) in which the "Satisfaction with life Scale" was applied, consisting of 5 items that measure self-perception of life satisfaction. Nonparametric statistics (Mann-Whitney U test) were used to explore differences in scores according to sex and school environment, in addition to Spearman's Rho test to identify associations between scale scores and students' age and BMI. Significant differences were obtained in terms of sex in favor of the male gender, and between the two environments of the centers in favor of the rural ones. In addition, the two variables explored (age and BMI) showed significant inverse associations with life satisfaction levels. Therefore, educational interventions and policies must take this information into account to design and develop actions aimed at improving this cognitive factor.

There is a correlation between nutritional status, Self-Rated Health and Life Satisfaction? Evidence from 2018 Health Behaviour in School-aged Children cross sectional study in a sample of Italian adolescents living in Tuscany Region

Background

Overweight has been associated with several social and phycological problems and is perceived as one of the major health care challenges to focus on in the future. The purpose of the study is to investigate the correlations among nutritional status, assessed by the Body Mass Index, the perception of one's own health status and Life Satisfaction, detected in Italian adolescents living in Tuscany Region, and to investigate the influence of gender on them.

Methods

A statistically representative sample of 2760 Tuscan adolescents aged 11, 13 and 15 was involved in the 2018 Health Behaviours at School-aged Children survey. The participants were divided into three nutritional status class: underweight, normal weight and overweight (overweight + obese).

Results

The results show that there is a statistically significant difference in all categories between boys and girls aged 13 and 15 years; in girls aged 11 and 13 years, the Life Satisfaction of the overweight group is statistically lower than that of normal and underweight groups; Self-Rated Health is statistically lower in all age groups for overweight individuals compared to normal weight children, except for 11-year-old females.

Conclusions

Viewing the psychosocial problems related to overweight, more attention and care must be placed on adolescents to ensure their healthier development.

Role of Satisfaction with Life, Sex and Body Mass Index in Physical Literacy of Spanish Children

Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing life satisfaction (LS) given its positive relationship with physical activity. A single-measure cross-sectional correlational study was carried out, involving 135 children aged 8-12 years from Extremadura. They were administered the SWLS questionnaire and the Canadian assessment of physical literacy (CAPL-2). Significantly higher levels of PL (p = 0.010) were found in normal-weight children compared to overweight and obese children, due to the physical competence domain score (p < 0.001). PL was directly related to SWLS (p < 0.001), but inversely related to BMI (p = 0.018). The daily physical activity behaviour domain was explained by SWLS (p < 0.001) and sex (p < 0.001). Physical competence was described by SWLS (p < 0.001) and BMI (p = 0.045). Finally, the motivation and confidence domain were only significantly associated with SWLS (p < 0.001). It was concluded that boys and girls of normal weight achieved higher levels of PL and LS than those with overweight and obesity, establishing a negative relationship of PL with BMI and positive with LS.

A Close Association between Body Weight, Health-Related Quality of Life, and Risk Behaviors in a Sample of Italian High School Students

INTRODUCTION

Adolescents experience rapid physical, cognitive, and psychosocial growth with different factors contributing to health and well-being. In this view, an important role is played by body weight and related perceptions. The purpose was to determine, in a sample of Italian high school students, whether health-related quality of life (HRQoL) is associated with the different weight status categories (underweight, normal weight, overweight, obese), even considering sex differences.

MATERIAL AND METHODS

Data were collected from 1826 adolescents (n = 735 males). HRQOL was analyzed using the Italian version of KIDSCREEN-52.

RESULTS

Overweight adolescents showed reductions in psychological well-being (p < 0.05) and self-perception (p < 0.05) compared with individuals in other BMI categories. Subjects with obesity reported increased bullying victimization (p < 0.05) and reductions in self-perception and eating disorders (p < 0.001), while underweight individuals were characterized by altered adherence to the Mediterranean diet (p < 0.001), eating disorders (p < 0.001), and problematic use of social media (p < 0.05). No sex differences were found, except for socio-economic status perceptions, where underweight girls reported higher economic well-being than boys (p < 0.05).

CONCLUSIONS

Our findings may suggest that there is an association between weight status categories and HRQoL that is more pronounced in underweight and overweight adolescents. The association between BMI categories and psychosocial dimensions opens the need to define specific domains on which such preventive interventions should focus, always through a personalized perspective.

Reliability, acceptability, validity and responsiveness of the CHU9D and PedsQL in the measurement of quality of life in children and adolescents with overweight and obesity

BACKGROUND

The Paediatric Quality of life Inventory (PedsQL^TM) Generic Core Scales and the Child Health Utilities 9 Dimensions (CHU9D) are two paediatric health-related quality of life (HRQoL) measures commonly used in overweight and obesity research. However, no studies have comprehensively established the psychometric properties of these instruments in the context of paediatric overweight and obesity. The aim of this study was to assess the reliability, acceptability, validity and responsiveness of the PedsQL and the CHU9D in the measurement of HRQoL among children and adolescents living with overweight and obesity.

SUBJECTS/METHODS

Subjects were 6544 child participants of the Longitudinal Study of Australian Children, with up to 3 repeated measures of PedsQL and CHU9D and aged between 10 and 17 years. Weight and height were measured objectively by trained operators, and weight status determined using World Health Organisation growth standards. We examined reliability, acceptability, known group and convergent validity and responsiveness, using recognised methods.

RESULTS

Both PedsQL and CHU9D demonstrated good internal consistency reliability, and high acceptability. Neither instrument showed strong convergent validity, but PedsQL appears to be superior to the CHU9D in known groups validity and responsiveness. Compared with healthy weight, mean (95%CI) differences in PedsQL scores for children with obesity were: boys -5.6 (-6.2, -4.4); girls -6.7 (-8.1, -5.4) and differences in CHU9D utility were: boys -0.02 (-0.034, -0.006); girls -0.035 (-0.054, -0.015). Differences in scores for overweight compared with healthy weight were: PedsQL boys -2.2 (-3.0, -1.4) and girls -1.3 (-2.0, -0.6) and CHU9D boys: no significant difference; girls -0.014 (-0.026, -0.003).

CONCLUSION

PedsQL and CHU9D overall demonstrated good psychometric properties, supporting their use in measuring HRQoL in paediatric overweight and obesity. CHU9D had poorer responsiveness and did not discriminate between overweight and healthy weight in boys, which may limit its use in economic evaluation.

The Study of Nutrient Intake and Adolescent Girls' Quality of Life in a Rural Area of Indonesia

An inadequate nutrient intake correlates with malnutrition, a problem affecting many adolescents worldwide. Nutrient intake is associated with quality of life (QoL). Our study analyzed the relationship between nutrient intake and adolescents’ QoL. We conducted a cross-sectional study. Through simple random sampling, 157 adolescent girls were selected. Nutrition status was assessed using anthropometric measurements. Nutrient intake was collected using the food frequency questionnaire (FFQ). WHOQOL BREF was used to explore adolescent girls’ quality of life. The median of nutrient intake: energy (908.25 kcal); protein (24.16 g); carbohydrate (128.89 g); fat (21.89 g); vitamin A (77.10 mg); vitamin E (1.40 mg); vitamin B1 (0.19 mg); vitamin B2 (0.29 mg); vitamin B6 (0.45 mg); folic acid (35.13 mg); vitamin C (12.60 mg); calcium (197.46 mg); magnesium (93.72 mg); iron (2.64 mg); and zinc (2.09 mg). The adolescents’ QoL scores were physical health 44 (25–81), psychological domain 56 (19–94), social relationships 56 (19–94), and environmental domain 56 (31–100). The strongest correlations were between (1) physical health with carbohydrates, vitamin C, and fat; (2) psychological domain with calcium; (3) social relationships with carbohydrates and vitamin C; and (4) environmental domain with BMI and zinc. There was a significant positive correlation between the intake of some nutrients and adolescents’ QoL, despite the observation of some significant negative correlations. The findings of this study indicate that more attention should be focused on adolescents’ nutrient intake in order to improve their QoL.

The association between social capital indicators and psychological distress in Catalan adolescents

According to the WHO, globally, one in seven adolescents experiences a mental disorder, being in a detrimental situation toward educational achievement, social cohesion, future health and life chances. Calls to identify risk and resilience factors to develop effective preventive actions have been made. Following a systemic approach, we conducted a cross-sectional study on the relationship between social capital and psychological distress in a sample of Catalan adolescents in Barcelona, taking into account a range of other relevant aspects at different levels influencing mental health, including gender, age, migrant status, family background, lifestyle factors, body mass index, and self-rated health. Data were collected through validated questionnaires in December 2016 from 646 of 14- to 18-year-old adolescents from three public and private high schools in Barcelona (Spain). Data analysis included descriptive analysis, a correlational study and logistic regression to obtain the odds ratio for social capital indicators to be associated with psychological distress. Our results suggest that reporting higher levels of family support and higher levels of teacher-student trust reduce the likelihood of suffering psychological distress. Higher levels of neighborhood informal control were associated with mental health, but a possible detrimental effect cannot be ruled out. Being a girl, reporting low self-rated health or higher media use was also associated with higher likelihood of psychological distress. Current results may encourage interventions that focus on social capital as a means to reduce psychological distress and foster well-being in youth.

Time Spent on Daily Activities and Its Association with Life Satisfaction among Czech Adolescents from 1992 to 2019

Life satisfaction, an important precursor of adolescents’ well-being, is linked to daily activities. Substantial changes have been noted in adolescents’ daily activities over the years, raising the question of possible consequences for life satisfaction. This study aimed to explore changes in adolescents’ life satisfaction and their time spent on daily activities (sleeping, engaging in sports, online gaming, school commuting, time spent at school) and further investigate the associations between adolescents’ life satisfaction and these daily activities. The sample comprised 2715 adolescents from birth cohorts surveyed at four time points between 1992 and 2019. Participants were administered the Daily Activities Inventory and the Berne Questionnaire on Adolescents’ Well-Being. Robust ANOVA with post hoc tests and spline regression were employed. We found cohort differences in sleep duration (8.6 h a day on average in 1992 and 7.5 in 2019). Sleep duration of 8 h and 1 h of sports activities had a beneficial effect on life satisfaction, while more than 1 h of online gaming had a negative impact. Neither school attendance nor commuting to school was associated with adolescents’ life satisfaction. The results of this study can inform public-health policies to promote sleeping and sports habits in adolescence.

Study Protocol for Evaluation of an Extended Maintenance Intervention on Life Satisfaction and BMI Among 7-14-Year-Old Children Following a Stay at a Residential Health Camp in Denmark

Background: It is challenging to maintain effects of public health interventions. For residential health camps benefits often disappear as the child returns home. Furthermore, long-term effects are often not measured or reported. This paper presents the study protocol for an evaluation of an extended maintenance intervention offered to children who have completed a 10-week residential health camp at one of the five Danish Christmas Seal Houses (DCSH). The target group of DSCH is 7–14-year-olds with social, mental, and/or overweight issues and the overall aim of the camp is to increase life satisfaction and a healthy lifestyle. The primary aim of this study is to assess the effectiveness of the maintenance intervention on children's life satisfaction (primary outcome) and BMI Z-score (secondary outcome) 1 year after health camp.

Methods: The extended maintenance intervention is developed by DCSH and delivered to each child and family individually by an intervention coordinator to help children maintain positive benefits of the health camp on life satisfaction and health behaviors after returning to their homes. Intervention activities target the child and the family. The effect will be tested in a quasi-experimental design: The intervention is offered to half of the children at one of the five DSCH (intervention group, N~144) while the other half and the children at the other four DSCH receive a standard maintenance intervention (control group, N~894). Children will complete questionnaires on life satisfaction measured by an adapted version of the Cantril ladder and height and weight prior to health camp, at the end of health camp, 3 months and 1 year after the end of health camp. To enable per protocol analysis and nuanced interpretation of effect estimates, we will monitor the implementation of the intervention by a process evaluation study among children, parents, and follow up coordinators using qualitative and quantitative methods.

Discussion: We present a systematic approach to evaluating practice-based interventions in a research design. The study will provide new knowledge on the effectiveness of individualized maintenance interventions on long-term effects on life satisfaction and weight loss among children.

Trial registration: Prospectively registered at Current Controlled Trials ISRCTN 13011465 https://www.isrctn.com/ISRCTN13011465

Psychopathological Symptoms and Well-Being in Overweight and Underweight Adolescents: A Network Analysis

Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on data of 344 overweight adolescents (>90th BMI-percentile) and 423 underweight adolescents (<10th BMI-percentile) drawn from a large community sample (10-19 years) including behavioral and emotional problems (Youth Self-Report), eating disorder risk (SCOFF) and well-being variables (KIDSCREEN). Additionally, psychopathology and well-being scores of overweight and underweight individuals were compared with 1.560 normal weight adolescents. Compared to their normal weight peers, overweight adolescents showed elevated psychopathology and eating disorder risk as well as reduced well-being. Underweight adolescents reported increased levels of internalizing problems but no increased eating disorder risk or reduced well-being. The network analysis revealed that anxious/depressed mood and attention problems were the most central and interconnected nodes for both overweight and underweight subsamples. Among underweight individuals, social problems and socially withdrawn behavior additionally functioned as a bridge between other nodes in the network. The results support psychological interventions focusing on improving mood, coping with negative emotions and tackling inner tension.

Urban Forest Health Intervention Program to promote physical activity, healthy eating, self-efficacy and life satisfaction: impact on Israeli at-risk youth

The aim of this study was to evaluate an urban forest intervention program effect on physical activity, healthy eating habits, self-efficacy and life satisfaction (LS) among Israeli at-risk youth. The quasi-experimental study ran from September 2016 to June 2017; participants were randomly selected. There were 76 total study participants: 53 in the intervention and 23 in the control group. Participants ranged in age from 15 to 18 years. Questionnaires were administered to intervention and control groups before and after the intervention. Univariate and multivariable analyses evaluated the intervention effect. Repeated measures analyses of covariance were calculated to assess change in group differences. An increase was found in measures of physical activity in the intervention group (p < 0.001), while no change was noted in the control group. Healthy eating increased in both groups (p = 0.007), with no significant difference between them (p = 0.165). Unhealthy eating decreased significantly in the intervention group (p = 0.002) and increased in the control group (p = 0.007). Self-efficacy increased in the intervention group (p < 0.001), while no change was noted in the control group (p = 0.353). Likewise, LS increased in the intervention group (p < 0.001), while no change was found in the control group (p = 0.657). Findings indicate that the intervention was efficacious in increasing physical activity, healthy eating habits, self-efficacy, and LS. The effectiveness of this intervention among larger samples is warranted in future prospective studies.

Relationship between Physical Activity, Sedentary Behavior, and Anthropometric Measurements among Saudi Female Adolescents: A Cross-Sectional Study

Overweight and obesity are becoming increasingly prevalent among children and adolescents in Saudi Arabia and are an emerging cause of non-communicable diseases (NCDs). Lifestyle factors, such as insufficient levels of physical activity and sedentary behaviors, are responsible for the increased prevalence of NCDs. This study aimed to determine the association between physical activity levels, sedentary behaviors, and anthropometric measurements in Saudi female adolescents. A cross-sectional study was carried out among 399 healthy female adolescent students aged 13–14 years in Arar, Saudi Arabia. The participants were randomly selected from different schools and their anthropometric measurements were determined. The Physical Activity Questionnaire for Older Children (PAQ-C) and the Adolescent Sedentary Activity Questionnaire (ASAQ) were used to assess their physical activity levels and sedentary behaviors, and an analysis was conducted using IBM SPSS software version 25. A multiple linear regression model was used to determine the association between the variables. The majority of the participants had a normal body mass index (BMI; 79.4%) and waist circumference (WC; 62.4%). A total of 74.4% had waist to height ratio (WHtR) < 0.5. About 92.7% of the participants were not meeting PA recommendations of 60 min of moderate to vigorous physical activity daily. The overall mean time spent on sedentary activities was high on both weekdays and weekend days at 357.64 ± 86.29 and 470.51 ± 147.64 min/day, respectively. Moreover, anthropometric measurement (BMI) was positively associated with age and negatively associated with sedentary behavior on weekends, while WHtR was positively associated with age. The multiple linear regression analysis also showed that age and sedentary behavior significantly predicted BMI among the study participants (F (2, 396) = 4.346, p < 0.014) and age was the only significant predictor of WHtR (F (1, 397) = 16.191, p ≤ 0.001). This study revealed that most of the female Saudi adolescents undertook low levels of activity and high levels of sedentary behaviors. Sedentary behaviors were significantly associated with their BMI. Accordingly, an intervention program on healthy lifestyles is important to improve Saudi female adolescents’ lifestyles.

Relationship of Overweight and Obesity with Body Self-Image Dissatisfaction in Urban Mediterranean Adolescents

The aim of this study was to analyze whether weight status has a relationship with the prevalence of body self-image dissatisfaction in Mediterranean urban teenagers. A series of 809 adolescents aged 11 to 17 years underwent anthropometric measurements according to ISAK protocols and completed the Body Shape Questionnaire (BSQ). The overall overweight prevalence according to International Obesity Task Force (IOTF) criteria was 11.5%, and 2.7% for obesity. Girls showed higher overweight prevalence than boys (18.4% vs. 12.9%; p < 0.05). At the late adolescence period (16–17 y), obesity was observed in the boys but not in the girls (8.7% vs. 0%; p < 0.01). There was a relative low prevalence of body image (BI) dissatisfaction among participants (boys 17.3%; girls 22.7%). In the late adolescence period, the girls were more often classified as being dissatisfied (31%). A weak correlation between the BSQ scores and all the anthropometric variables related to the adiposity profile was detected only in the boys. A logistic regression confirmed that female adolescents and the late pubertal period had a significant association with body dissatisfaction, regardless of their weight status. As BI are not related to weight status measured by body mass index (BMI) percentiles, other factors beyond anthropometry deserve further research to explain BI concerns specifically in girls.

Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight

There is substantial variability in weight loss outcomes. Psychosocial characteristics underlying outcomes require better understanding, particularly on self-managed digital programs. This cross-sectional study examines differences in psychosocial characteristics by weight loss and engagement outcome, and which characteristics are most associated with weight loss, on a self-managed digital weight loss program. Some underexplored psychosocial characteristics are included, such as flourishing, or a sense of meaning and purpose in life. A questionnaire was emailed to a random sample of 10,000 current users at week 5 in the program and 10,000 current users at week 17. The questionnaire was completed by 2225 users, and their self-reported weight and recorded program engagement data were extracted from the program’s database. Multiple comparison tests indicated that mental health quality of life, depression, anxiety, work-life balance, and flourishing differed by weight loss outcome at program end (week 17; ≥5%, 2–5%, below 2%) and by engagement tertile at program beginning and end (weeks 5 and 17). Only anxiety was associated with weight loss in a backward stepwise regression controlling for engagement and sociodemographic characteristics. Flourishing did not predict weight loss overall but predicted the weight loss outcome group. Our findings have implications for creating more effective interventions for individuals based on psychosocial characteristics and highlight the potential importance of anxiety in underexplored self-managed digital programs.

The Role of Physical Activity and School Physical Education in Enhancing School Satisfaction and Life Satisfaction

The aim of this study was to understand the role of school satisfaction on life satisfaction, according to gender, age, body mass index (BMI), and physical activity (PA) level. This was a cross-sectional descriptive study, carried out on 2823 adolescents (1396 boys and 1427 girls), aged between 12 and 16. A specific questionnaire to measure life satisfaction (Brief Multidimensional Student Life Satisfaction Scale (BMSLSS)), a questionnaire to measure satisfaction with school (“Life circumstances of Young people: School”), and the International Physical Activity Questionnaire (IPAQ) were used to analyze PA practice. Gender, age, and BMI were used as control variables. In general, the main results showed that school satisfaction had a clear role in life satisfaction. Similarly, the findings allowed us to conclude that the role of school satisfaction on life satisfaction was more evident in male school children, those who were older, or those who have a higher BMI. The regular practice of PA enhanced school satisfaction and its role on life satisfaction. Therefore, it is very important to assess the importance of school satisfaction as a determinant of quality of life and the adoption of healthy habits, recognizing the fundamental role of teachers in this regard.

A bio-ecological framing of evidence on the determinants of adolescent mental health - A scoping review of the international Health Behaviour in School-Aged Children (HBSC) study 1983-2020

This paper extracts, organises and summarises findings on adolescent mental health from a major international population study of young people using a scoping review methodology and applying a bio-ecological framework. Population data has been collected from more than 1.5 million adolescents over 37 years by the Health Behaviour in School-Aged Children: WHO Cross-National (HBSC) Study. The paper reviews the contribution that this long standing study has made to our understanding of the individual, developmental, social, economic, cultural determinants of adolescent mental health by organising the findings of 104 empirical papers that met inclusion criteria, into individual, microsystem, mesosystem and macrosystem levels of the framework. Of these selected papers, 68 were based on national data and the other 36 were based on international data, from varying numbers of countries. Each paper was allocated to a system level in the bio-ecological framework according to the level of its primary focus. The majority (51 papers) investigate individual level determinants. A further 28 concentrate primarily on the microsystem level, 6 on the mesosystem level, and 29 on the macrosystem level. The paper identifies where there is evidence on the determinants of mental health, summarises what we have learned, and highlights research gaps. Implications for the future development of this population health study are discussed in terms of how it may continue to illuminate our understanding of adolescent mental health in a changing world and where new directions are required.